Can sex be a trigger for cardiac arrest?

In the first study of its kind, US researchers have found that sexual activity is unlikely to trigger sudden cardiac arrest (SCA), but when the two are associated, the results tend to be fatal.

In men, around one in a hundred SCAs were associated with sexual activity, and one in a thousand for women, according to the study presented this week at the American Heart Association Meeting and simultaneously published in the Journal of the American College of Cardiology.

All SCA cases from 2002 to 2015 in a population sample of about a million people in Portland, Oregon were prospectively examined. A total of 4557 SCA cases were identified, of which only 34 were linked to sexual activity. Of those, cardiac arrest occurred during sexual intercourse in 18 cases, and immediately after in 15 cases. All but two of the cases were male.

Men who suffered a SCA related to sexual activity were on average five years younger, more likely to have had a history of cardiovascular disease and had a higher rate of ventricular fibrillation/tachycardia than SCA cases where sexual activity was not a factor.

Of the 34 cases of SCA linked to sexual activity, only six survived to hospital discharge. Only a third of cases received bystander CPR, despite the fact that sexual partners were necessarily present.

“These findings highlight the importance of continued efforts to educate the public on the importance of bystander CPR for SCA, irrespective of circumstance,” commented Dr Sumeet Chugh, a senior study author and associate director of the Cedars-Sinai Heart Institute in Los Angeles, California.

The authors said one limitation of the study was that frequency of sexual activity was unknown, so researchers couldn’t determine relative risk compared with rest or other physical activity.

They also noted that some cases of SCA related to sexual activity might also involve medications, stimulants and alcohol use.

You can read the research letter published in the Journal of the American College of Cardiologyhere and access the meeting poster here.